title: Nascent deep microbleeds and stroke recurrences.
abstract: BACKGROUND
  Cerebral microbleeds (MBs) on gradient echo T2*-weighted magnetic resonance imaging (MRI) scans are associated with the severity of cerebral microangiopathies. This study investigated the contributions of nascent deep MBs to stroke recurrence.
  
  
  METHODS
  We prospectively analyzed nascent deep MBs in patients admitted to our hospital who were treated for index strokes between April 2004 and November 2009. The number of nascent deep MBs was counted on T2*-weighted MRI scans around 1 year after the index strokes, and compared to previous MRIs on admission. Stroke recurrence-free rate curves were generated using the Kaplan-Meier method using the log-rank test. The odds ratio for nascent deep MBs was derived using a multivariate logistic regression model that was based on recurrent strokes and other risk factors.
  
  
  RESULTS
  We evaluated the MRIs (interval between MRIs 14.6 ± 5.9 months) of 508 patients (207 women; 68.9 ± 11.5 years), with a follow-up period of 44.1 ± 15.4 months. Repeated T2*-weighted MRI scans revealed 256 nascent deep MBs in 116 of 508 patients. The incidence of deep intracerebral hemorrhage was significantly greater in patients with nascent deep MBs than those without (2.0% vs 0.4% per year, respectively; P < .0001). Multivariate analyses revealed that the rate of nascent deep MBs was significantly elevated in patients whose stroke recurrences took the form of deep intracerebral hemorrhages (odds ratio 5.41; P = .007), when adjusted for hypertension, preexisting MBs, and other risk factors.
  
  
  CONCLUSIONS
  Our findings suggested that nascent deep MBs might be associated with stroke recurrence, in particular with deep intracerebral hemorrhage.
authors.affiliation: Department of Neurosurgery, Kushiro City General Hospital, Hokkaido, Japan. Electronic address: timaizum@d9.dion.ne.jp.
authors.forename: Toshio
authors.initials: T
authors.lastname: Imaizumi
authors.affiliation: Department of Neurosurgery, Kushiro City General Hospital, Hokkaido, Japan.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Inamura
authors.affiliation: Department of Neurosurgery, Kushiro City General Hospital, Hokkaido, Japan.
authors.forename: Ikuhide
authors.initials: I
authors.lastname: Kohama
authors.affiliation: Department of Neurosurgery, Kushiro City General Hospital, Hokkaido, Japan.
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Yoshifuji
authors.affiliation: Department of Neurosurgery, Kushiro City General Hospital, Hokkaido, Japan.
authors.forename: Tatsufumi
authors.initials: T
authors.lastname: Nomura
authors.affiliation: Department of Neurosurgery, Kushiro City General Hospital, Hokkaido, Japan.
authors.forename: Katsuya
authors.initials: K
authors.lastname: Komatsu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002533:Cerebral Angiography / Q000379:methods; D002543:Cerebral Hemorrhage / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D038524:Diffusion Magnetic Resonance Imaging; D004185:Disability Evaluation; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D012720:Severity of Illness Index; D020521:Stroke / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D013997:Time Factors; D014057:Tomography, X-Ray Computed
keywords: Cerebral microbleeds; intracerebral hemorrhage; recurrence; risk factor; stroke